IMPACT Regs Key To Successful 2016, Top Lobbyist Says

1/11/2016

Bill Myers

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Washington,
D.C.—Federal regulations that would create uniform measures for health care
quality represent the most pressing issue for providers in 2016, the top lobbyist
for the nation’s largest skilled nursing advocacy group says.

“If we
get this wrong, we’ll have a faulty foundation,” Clif Porter II says of pending
rules designed to implement 2014’s IMPACT Act. “We’ve got to make sure this is
done right."

Porter,
the senior vice president for government affairs at the American Health Care
Association (AHCA)/National Center for Assisted Living, spoke with reporters in a
conference call from AHCA’s national headquarters in Washington, D.C. He anticipated
a relatively quiet year on the Hill in 2016—if only because “history tells us
that the legislative agenda, in a presidential election year, tends to be quiet.”

‘Need For Speed’

That
isn’t true of the regulatory agenda, though, Porter says. He and his colleagues
fully expect a flurry of rules and rulemaking notices in the next six months,
as President Obama seeks to carve his last policy monuments before leaving
office early in 2017.

“There’s
a lot of work we’ve got to do,” Porter says. “We respect the need for speed,
but we’re also sensitive that these measures need to be done in a thoughtful
way.”

Among
the concerns around the IMPACT regulations, Porter says, is that regulators
will focus more on the price of health care, and not its value.

“We’ve
got to focus on ensuring we have appropriate outcomes in the measures,” Porter
says. “Every time somebody gets to go home, every time somebody improves, we
see that as a success.”

Mega-Rule Pending

Providers
are anxiously anticipating rules from the Centers for Medicare & MedicaidServices (CMS) that cover everything from how and when nurse assistants should call an
ambulance to how and when unsatisfied customers can sue care centers. Porter
calls the pending regulations, “the mega-rule.”

AHCA/NCAL
members flooded regulators with nearly 10,000 comments while CMS was
considering the rules.

“I trust
that CMS is going to be thoughtful about this,” Porter says. “My hope is that
whatever rule is finalized will take into account all the comments that were
made.”

Arbitration Angst

Among
the proposed rules in the pending regulations are provisions that would prevent
providers from requiring families or residents to commit to arbitration instead
of going directly to civil court in disputes. That “issue was the one that
created absolutely the most angst,” Porter says, and AHCA/NCAL plans to work
with other groups to convince regulators that the proposed rule is unnecessary
and overly burdensome.

“Arbitration,
on a broad scale, remains a concern—not just in health care,” he says.

Porter
was also asked about the NOTICE Act, which requires hospitals to notify
Medicare patients when they’re being placed on observation status. Observation
stays prevent Medicare patients from being able to able to tap into their
skilled nursing benefits.

Porter
says the act is a great first step, but only “a partial victory.”

“The
NOTICE Act is incredibly important,” he says, “but it doesn’t address the
problem. So we’ve got to keep hammering away at it.”

AHCA/NCAL
and its allies are also continuing their push for payment reform, Porter says.
The next, crucial step in the process is to get a dollar score from the
Congressional Budget Office, he says.